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Jieguo stated: Contracting heatstroke while at rest is termed *Zhongshu* (Summerheat Stroke); contracting it during physical exertion is termed *Zhongre* (Summerheat Heat). *Zhongshu* belongs to Yin patterns, whereas *Zhongre* belongs to Yang patterns.

Dongyuan stated: Those who contract illness by seeking coolness in deep halls and large mansions are named as having *Zhongshu*. Their symptoms must include headache, aversion to cold, bodily stiffness and urgency, pain in the limbs and joints, mental vexation, a sensation of fire on the skin, and anhidrosis (absence of sweating). This occurs because the yin-cold of the dwelling suppresses the body's yang qi, preventing its free expansion and diffusion. The primary formula for treatment is Dashun San (Greatly Smooth Powder). Conversely, those who contract illness through labor under the midday sun, such as travelers or farmers, are named as having *Zhongre*. Their symptoms must include severe headache, agitation and fever, aversion to heat, burning hot skin upon touch, intense thirst with excessive drinking, profuse sweating, and lethargy with lack of energy to move. This results from heavenly heat injuring Lung Qi externally. The primary formula for treatment is Cangzhu Baizhu Tang (Atractylodes and White Tiger Decoction) — *Note: Text says Cangzhu Baihu Tang*.

I privately hold that "Summerheat" and "Heat" are the climatic commands of summer, prevalent throughout heaven and earth. If a person engages in labor or suffers from hunger, causing their Yuan Qi (Original Qi) to become deficient and insufficient to resist the extreme exuberance of the heavenly climate, they will be injured and fall ill. This is named *Zhongshu*, also named *Zhongre*. In reality, they are one and the same. Why, then, do we now distinguish them based on movement versus stillness?

Those who contract Summerheat-Heat indeed mostly occur among those engaged in labor. Labor leads to deficiency; deficiency allows pathogenic factors to enter; entry of pathogenic factors leads to disease. If there is no deficiency, even if the heavenly climate is exuberant, there is no pathway for it to cause injury. Those who seek coolness in deep halls and large mansions and present with symptoms such as headache and aversion to cold are likely suffering from conditions similar to Cold Damage (Shanghan). They should not be named *Zhongshu*. The reason for their mental vexation and sensation of fire on the skin is not due to Summerheat pathogenic factors, but rather due to the body's internal Yang Qi being suppressed by yin-cold. Since it is not a Summerheat pathogen, how can it be called *Zhongshu*? If one wishes to treat this, dispersal using pungent-warm and light-yang agents would suffice.

Regarding the formula Dashun San, Licorice Root (Gancao) is used in the largest quantity, followed by Dried Ginger (Ganjiang), Apricot Kernel (Xingren), and Cinnamon Bark (Rougui). Except for Cinnamon Bark, the other three ingredients are stir-fried. Investigating its original intent, it was established primarily for cases where one had been exposed to latent Summerheat, drank excessively, leading to dampness affecting the Spleen and Stomach, vomiting, indistinguishable food and water, and disharmony of the Zang-Fu organs. Therefore, both Licorice Root and Dried Ginger were roasted over fire. Furthermore, Cinnamon Bark (Rougui) was used instead of Cinnamon Twig (Guizhi), as they are warming middle-jiao herbs. The inclusion of Apricot Kernel merely utilizes its ability to direct Qi downward. If this medicine is used to treat the condition contracted through stillness, I fear it will fail to resolve the issue and may instead increase internal vexation.

Modern secular practitioners often fail to understand this, generally stating: "In summer, Yin Qi resides internally; therefore, Dashun San is an essential medication." Alas, this is a grave error. Is it not too serious? The so-called "Yin Qi" is not "Cold Qi." It is simply that in summer, Yang Qi diffuses outward, while Yin Qi remains inward. How can one superficially view Yin Qi as Cold Qi and thus employ warm-hot medications? If Yin were truly Cold, why would people drink water in summer?

Although Cangzhu Baihu Tang (Atractylodes and White Tiger Decoction) is suitable for use, it cannot be regarded as a universal remedy. One must refer to various formulas for treating Summerheat and apply them according to the specific manifestations observed, which aligns with principle. As for the so-called condition contracted through stillness, even if it occurs during the summer months, it is not a Summerheat disease. It should be differentiated clearly to prevent later generations from being confused by apparent similarities and underlying differences.